Randomized controlled trial comparing somatostatin with octreotide in the prevention of complications after pancreatectomy.

Hepatogastroenterology

Medicosurgical Department of Hepatogastroenterology, ULB Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium.

Published: January 2009

Background/aims: The postoperative morbidity following pancreaticoduodenectomy (PD) remains very high. Somatostatin or octreotide are indicated in the prevention of pancreatic stump-related complications. The aim of this study is to compare the efficacy of somatostatin and octreotide after PD.

Methodology: Between November 2000 and December 2003 we collected prospectively clinical and biological data from patients with a benign or malignant pancreatic tumor requiring a PD. Fifty patients were randomized into two groups, 25 treated with somatostatin (group S) and 25 with octreotide (group O).

Results: There was no postoperative death. Complications occurred in 20 patients (40%), 11 in group S, 9 in group O (NS). General complications occurred in 7 patients in group S, and 5 patients in group O. Local complications related to the pancreatic stump were found in 4 patients in both groups. At the end of the period of administration of the two study drugs, 2 patients (8%) had a pancreatic fistula in group S and 3 in group O (12%) (p=0.52). A trend of more rapid decreased level of amylase and lipase concentrations in surgical drainage was observed in group S but it is not statistically significant (p=0.29).

Conclusions: In patients requiring PD for pancreatic tumor, somatostatin and octreotide seem to behave similarly in the postoperative period.

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